Predicting risk of suicide attempt using history of physical illnesses from electronic medical records

BACKGROUND: Although physical illnesses, routinely documented in electronic medical records (EMR), have been found to be a contributing factor to suicides, no automated systems use this information to predict suicide risk.

OBJECTIVE: The aim of this study is to quantify the impact of physical illnesses on suicide risk, and develop a predictive model that captures this relationship using EMR data.

METHODS: We used history of physical illnesses (except chapter V: Mental and behavioral disorders) from EMR data over different time-periods to build a lookup table that contains the probability of suicide risk for each chapter of the International Statistical Classification of Diseases and Related Health Problems, 10th Revision (ICD-10) codes. The lookup table was then used to predict the probability of suicide risk for any new assessment. Based on the different lengths of history of physical illnesses, we developed six different models to predict suicide risk. We tested the performance of developed models to predict 90-day risk using historical data over differing time-periods ranging from 3 to 48 months. A total of 16,858 assessments from 7399 mental health patients with at least one risk assessment was used for the validation of the developed model. The performance was measured using area under the receiver operating characteristic curve (AUC).

RESULTS: The best predictive results were derived (AUC=0.71) using combined data across all time-periods, which significantly outperformed the clinical baseline derived from routine risk assessment (AUC=0.56). The proposed approach thus shows potential to be incorporated in the broader risk assessment processes used by clinicians.

CONCLUSIONS: This study provides a novel approach to exploit the history of physical illnesses extracted from EMR (ICD-10 codes without chapter V-mental and behavioral disorders) to predict suicide risk, and this model outperforms existing clinical assessments of suicide risk.

History of physical astronomy, from the earliest ages to the middle of the 19th century.

Mode of access: Internet.

Participation in physical activity : perception of women with a previous history of gestational diabetes

The aim was to explore the perceptions of physical activity among women with previous gestational diabetes mellitus, in the context of preventing Type 2 diabetes mellitus.

Relationships of impulsivity and physical fighting history to alcohol -induced aggression in women

Research suggests women respond to the aggression-inducing effects of alcohol in a manner similar to men. Highly aggressive men are more prone to alcohol-induced aggression, but this relationship is less clear for women. This study examined whether alcohol consumption would differentially affect laboratory-measured aggression in a sample of aggressive and non-aggressive women and how those differences might be related to components of impulsive behavior. In 39 women recruited from the community (two groups: with and without histories of physical fighting) ages 21–40, laboratory aggressive behavior was assessed following placebo and 0.80 g/kg alcohol consumption (all women experienced both conditions). Baseline laboratory impulsive behavior of three impulsivity models was later assessed in the same women. In the aggression model (PSAP), participants were provoked by periodic subtractions of money, which were blamed on a fictitious partner. Aggression was operationalized as the responses the participant made to subtract money from that partner. The three components of impulsivity that were tested included: (1) response initiation (IMT/DMT), premature responses made prior to the completion of stimulus processing, (2) response inhibition (GoStop), a failure to inhibit an already initiated response, and (3) consequence sensitivity (SKIP and TCIP), the choice for a smaller-sooner reward over a larger-later reward. I hypothesized that, compared to women with no history of physical fighting, women with a history of physical fighting would exhibit higher rates of alcohol-induced laboratory aggression and higher rates of baseline impulsive responding (particularly for the IMT/DMT), which would also be related to the alcohol-induced increases aggression. Consistent with studies in men, the aggressive women showed strong associations between laboratory aggression and self-report measures, while the non-aggressive women did not. However, unlike men, following alcohol consumption it was the non-aggressive women's laboratory aggression that was related to their self-reports of aggression and impulsivity. Additionally, response initiation measures of impulsivity distinguished the two groups, while response inhibition and consequence sensitivity measures did not; commission error rates on the IMT/DMT were higher in the aggressive women compared to the non-aggressive women. Regression analyses of the behavioral measures showed no relationship between the aggression and impulsivity performance of the two groups. These results suggest that the behavioral (and potentially biological) mechanism underlying aggressive behavior of women is different than that of men. ^

The early history of man : with special reference to the Cap-Blanc skeleton / by Henry Field, Assistant Curator of Physical Anthropology.

no.26(1927)

The history of Vermont; with descriptions, physical and topographical.

Mode of access: Internet.

A brief history of epidemic and pestilential diseases : with the principal phenomena of the physical world, which precede and accompany them, and observations deduced from the facts stated : in two volumes /

Mode of access: Internet.

Researches into the physical history of mankind.

On t.-p. of v. 3: vol. III.-pt. 1.

The natural history of man; comprising inquiries into the modifying influence of physical and moral agencies on the different tribes of the human family.

Atlas, second edition: 6 maps. London: H. Baillière, 1855.

A history of physics in its elementary branches, including the evolution of physical laboratories.

Mode of access: Internet.

A general view of the world : comprising a physical, political, and statistical account of its grand divisions ... with their empires, kingdoms, republics, principalities, & c : exhibiting the history of geographical science and the progress of discovery to the present time :

Mode of access: Internet.

The eastern origin of the Celtic nations proved by a comparison of their dialects with the Sanskrit, Greek, Latin, and Teutonic languages. Forming a supplement to Researches into the physical history of mankind.

Mode of access: Internet.

An account of travels into the interior of southern Africa, in the years 1797 and 1798 : including cursory observations on the geology and geography of the southern part of that continent ; the natural history of such objects as occurred in the animal, vegetable, and mineral kingdoms ; and sketches of the physical and moral characters of the various tribes of inhabitants surrounding the settlement of the Cape of Good Hope. To which is annexed, a description of the present state, population, and produce of that extensive colony ; with a map constructed entirely from actual observations made in the course of the travels.

Vol. 2 has title: An account of travels into the interior of Southern Africa; in which is considered, the importance of the Cape of Good Hope to the different European powers, as a naval and military station ; as a territorial acquisition and commercial emporium in time of peace : with a statistical sketch of the whole colony ; comp. from authentic documents.

Researches into the physical history of mankind.

Mode of access: Internet.

Researches into the physical history of mankind.

Mode of access: Internet.